Central Illustration

Abstract

This JACC Scientific Expert Panel provides consensus recommendations for an update of the cardiovascular magnetic resonance (CMR) diagnostic criteria for myocardial inflammation in patients with suspected acute or active myocardial inflammation (Lake Louise Criteria) that include options to use parametric mapping techniques. While each parameter may indicate myocardial inflammation, the authors propose that CMR provides strong evidence for myocardial inflammation, with increasing specificity, if the CMR scan demonstrates the combination of myocardial edema with other CMR markers of inflammatory myocardial injury. This is based on at least one T2-based criterion (global or regional increase of myocardial T2 relaxation time or an increased signal intensity in T2-weighted CMR images), with at least one T1-based criterion (increased myocardial T1, extracellular volume, or late gadolinium enhancement). While having both a positive T2-based marker and a T1-based marker will increase specificity for diagnosing acute myocardial inflammation, having only one (i.e., T2-based OR T1-based) marker may still support a diagnosis of acute myocardial inflammation in an appropriate clinical scenario, albeit with less specificity. The update is expected to improve the diagnostic accuracy of CMR further in detecting myocardial inflammation.

Footnotes

Dr. Ferreira acknowledges support from the National Institute of Health Research Biomedical Research Centre, Oxford, and the British Heart Foundation Centre of Research Excellence, Oxford. Dr. Friedrich is a board member, adviser, and shareholder of Circle Cardiovascular Imaging. Dr. Kramer is a consultant for Bayer Healthcare; and has received a research grant from Biotelemetry. Dr. Schulz-Menger is a consultant for Bayer Healthcare and Siemens Healthineers. Dr. Gutberlet has received moderate speaker honoraria from Bayer, Bracco, Siemens, and Philips. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Toolbox

Thank you for your interest in spreading the word about JACC: Journal of the American College of CardiologyNOTE: We request your email address only as a reference for the recipient. We do not save email addresses.

Your Email *

Your Name *

Send To *

Enter multiple addresses on separate lines or separate them with commas.